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Book

Distal Clavicular Osteolysis

David C. Evans  1 , Jeremy D. Schroeder  1
In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.
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Affiliations
Book

Distal Clavicular Osteolysis

David C. Evans et al.

Excerpt

Distal clavicular osteolysis (DCO) is an atypical injury occurring most often in athletes and weight lifters, specifically those who perform repetitive overhead movements. The clavicle spans two of the four joints of the shoulder. The proximal clavicle interfaces with the sternum at the sternoclavicular (SC) joint, and the distal clavicle adjoins the acromion process to make the acromioclavicular (AC) joint. The AC joint receives its static stability from the AC joint capsule (AC ligaments) and the coracoclavicular ligaments; its dynamic stability from the deltoid and trapezius muscles.

Distal clavicular osteolysis results from repetitive excess load to the AC joint, typically through horizontal adduction, adduction, internal rotation, and forward/lateral flexion of the shoulder, such as bench pressing or overhead lifting. In theory, this repetitive loading causes micro-trauma to the subchondral bone of the distal clavicular head, resulting in subchondral cystic changes, disruption of the articular cartilage, and metaplastic bone formation with increased osteoclastic activity.

Cessation of weight lifting or other inciting activities may alleviate symptoms. Some therapies have shown promise to decrease pain and improve function.

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Conflict of interest statement

Disclosure: David Evans declares no relevant financial relationships with ineligible companies.

Disclosure: Jeremy Schroeder declares no relevant financial relationships with ineligible companies.

References

    1. Rios CG, Mazzocca AD. Acromioclavicular joint problems in athletes and new methods of management. Clin Sports Med. 2008 Oct;27(4):763-88. - PubMed
    1. Schwarzkopf R, Ishak C, Elman M, Gelber J, Strauss DN, Jazrawi LM. Distal clavicular osteolysis: a review of the literature. Bull NYU Hosp Jt Dis. 2008;66(2):94-101. - PubMed
    1. Patel DR, Breisach S. Evaluation and management of shoulder pain in skeletally immature athletes. Transl Pediatr. 2017 Jul;6(3):181-189. - PMC - PubMed
    1. Roedl JB, Nevalainen M, Gonzalez FM, Dodson CC, Morrison WB, Zoga AC. Frequency, imaging findings, risk factors, and long-term sequelae of distal clavicular osteolysis in young patients. Skeletal Radiol. 2015 May;44(5):659-66. - PubMed
    1. Nevalainen MT, Ciccotti MG, Morrison WB, Zoga AC, Roedl JB. Distal clavicular osteolysis in adults: association with bench pressing intensity. Skeletal Radiol. 2016 Nov;45(11):1473-9. - PubMed

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